'Tis the season to be SAD
Seasonal Affective Disorder is as natural as rain, snow and sunshine
By Patti Carmalt-Vener 12/19/2012
Even though it’s the holiday season, a low mood comes over me every December through February. I’m depressed and tired and have trouble concentrating at work. At night, I don’t sleep well and often get up in the middle of the night to binge eat, a habit that’s causing me to gain unwanted weight. I don’t feel much like socializing, either.
Late afternoons and early evenings are especially difficult. I hate that when I leave work at the normal time, it’s already dark and cold outside. I feel so much better when it’s a sunny day or even a rainy one. I hate those in-between gray days, where even my eyelids seem to feel heavy.
Yesterday, a friend told me there’s actually a psychological disorder that sounds very much like what I’m describing. Is that true?
Thanks for your help.
Seasonal Affective Disorder (SAD) is a depressive disorder that occurs during winter months, when days are short and dark. SAD was first described 27 years ago by Dr. Norman Rosenthal at the National Institutes of Health. Its symptoms include low mood, sleepiness, fatigue, irritability, anger, unclear thinking, increased appetite and weight gain, intense craving for carbohydrates (especially sweets) and less interest in work and social activities. On the lower level of the spectrum, it’s often referred to as the “winter blues.” With increasing symptoms, however, it can become a major depressive episode and may require professional treatment, including psychotherapy and medication. You should definitely seek medical help if your functioning impairment includes difficulty finishing tasks or getting to work regularly and on time, a decreased ability to concentrate, frequent crying spells or deep sadness, feeling that life is hopeless or no longer worthwhile, or experiencing excessive guilt or self-recriminations that you’d conclude inaccurate at other times in the year.
Causes for these symptoms are often mistakenly thought to be ordinary tiredness or the onset of the flu. The actual causes aren’t known for sure, but some evidence points to a lack of sun during winter months. Changes in light levels brought on by seasonal transition may decrease levels of melatonin, a hormone produced by the pineal gland that helps regulate sleep and waking cycles. In addition, mood and appetite changes associated with SAD may be due to inadequate serotonin, the neurotransmitter produced in the brain after carbohydrates are eaten and which also has to do with mood regulation, sleep, learning and constriction of blood vessels. This could explain cravings for sweets and other carbohydrates as a possible response to the brain’s need for serotonin.
A major treatment for SAD is light therapy, which exposes the patient to intense levels of fluorescent or incandescent light that mimics sunlight. The patient sits in front of a light box — a metal frame with fluorescent lights and a diffusing screen — for an hour in the morning. It is reported that up to 80 percent of SAD patients greatly improve after using the boxes. One can also increase light exposure by painting various rooms with brighter paints. Other treatments include spending more time outside, exercising, following a healthy diet, using prescription and non–prescription aids and pursuing psychotherapy. Commonly prescribed medications include anti-depressants such as Prozac; non-prescription medications or more natural products include St. John’s Wort, Omega-3 fatty acids and Vitamin D. None of these should be used without first consulting with your physician. Eating sweet and starchy carbohydrates may be a more natural way of dealing with milder forms of seasonal depression. Serotonin is increased by eating foods high in carbohydrates and relatively low in protein, such as popcorn, pretzels, cereals like Cheerios or Shredded Wheat, or graham crackers. Take advantage of where you live and consider vacationing or taking weekends away to Palm Springs or Desert Hot Springs.
Any depressive disorder may need psychotherapeutic treatment, where repressed feelings such as grief, anger and fear can be explored. In the case of SAD, it may be helpful to protect your energy by managing your time wisely, trying not to become too isolated and engaging in activities that interest you and which are healthy, such as sports, music or meditation. n
Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email firstname.lastname@example.org. Visit her Web site, patticarmalt-vener.com.